HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGR%UA AVENUE R E C E I V E D
FORT PIERCE, FL 34982-5652
(772)462-1553
SE 0 5 2018
FILLED LAND AFFIDAVIT ST, Lucie County, Permitting
I, the undersigned, am the owner of the following described property, SCANNED,
BY
YO - Y 3a - 00 3o - 000 - 8 & Lucie County
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for -a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St., Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Owner Name (Please Print) p
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF S7 , (— (A (,/ L-
ACKNOWLEDGED BEFORE M/E THIS � � � DAY OF (,/ (,{ f T 120
r BY (' 1 C k D 7'� WHO IS PERSONALLY KNOWN TO ME JUI�OR WHO HAS
PRODUCED I"v0 L AS IDENTIFICATION.
SIG TURF OF NOTARY PUBLIC TWJ OR PRINT NOTARY
C1 k OfoS� COMMISSION NUMBER
LYNN MERONE
�•t�Y pUB i
;•:�. .`�-; Notary Public - State of Florida
•; Commission #F GG 010657
SLCPDSD Revised04/11/2011 ,, P•' My Comm. Expires"Jul 12, 2020
��'' Bonded through National Notary Assn.